Provider Demographics
NPI:1801817853
Name:HILLCREST PHARMACY LLC
Entity Type:Organization
Organization Name:HILLCREST PHARMACY LLC
Other - Org Name:HILLCREST PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-356-7300
Mailing Address - Street 1:1 HILLCREST CTR
Mailing Address - Street 2:STE 110
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3740
Mailing Address - Country:US
Mailing Address - Phone:845-356-7300
Mailing Address - Fax:845-356-7836
Practice Address - Street 1:1 HILLCREST CTR
Practice Address - Street 2:STE 110
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-3740
Practice Address - Country:US
Practice Address - Phone:845-356-7300
Practice Address - Fax:845-356-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0325023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145650OtherPK
2145650OtherPK
3318246OtherOTHER ID NUMBER-COMMERCIAL NUMBER